Estrutura do esmalte humano e sua interface com sistemas adesivos

Esta tese sistematiza uma série de estudos dedicados à compreensão da interface do esmalte e sistemas adesivos. Para tanto, a estrutura da camada aprismática do esmalte em alta resolução pela microscopia eletrônica de varredura foi avaliada quanto a sua continuidade, espessura, distribuição nas faces coronárias e em fossas e fissuras, predominantemente em dentes decíduos não erupcionados. Foi também analisado pela microscopia eletrônica de varredura os efeitos do condicionamento de diferentes tipos de ácido e, em especial, do ácido fosfórico em diferentes concentrações, metodologias e tempos de aplicação. Estes trabalhos permitiram visualizar as principais ações ácidas desmineralizantes e os tipos de retenções no centro ou periferias dos prismas ou em ambas as regiões, bem como a profundidade e forma dos “tags” resinosos com carga e sem carga na intimidade do esmalte. No caso particular da aplicação dos selantes em fossas e fissuras foi também avaliada comparativamente a eficácia das técnicas invasivas ou não invasivas. Os últimos experimentos foram dedicados ao estudo da microinfiltração de diferentes sistemas adesivos e da resistência destes sistemas adesivos na estrutura do esmalte. Novos estudos merecem dar continuidade à linha de pesquisa de sempre priorizando o propósito de vincular os procedimentos aplicados com uma consistente e indispensável fundamentação de pesquisa básica no interesse da clínica odontopediátrica.

Influência da aplicação de cargas estáticas axias e não axais em próteses parciais fixas de três elementos, análise pela extensometria

Um bloco de poliuretano recebeu três implantes de hexagono externo, no posicionamento compensado. Para cada implante foi conectado o pilar protético microunit. Foram realizados cinco enceramentos com três coifas plásticas cada um, que foram fundidos em monobloco numa liga de cobalto-cromo. Foram colados quatro extensomêtros tangenciando cada implante, sendo dois extensomêtros para o implante central. Após o acabamento, as estruturas foram fixadas nos respectivos locais com o parafuso de retenção com torque de 10 Ncm, obtidos com um torquímetro. Para aplicação de carga sobre os corpos-de-prova foram selecionados cinco pontos de aplicação de carga. O dispositivo de aplicação de carga–DAC foi utilizado 30 kg de cargas verticais estáticas, empregando uma ponta esférica de 2 mm de diamêtro, durante 10 segundos em cada um dos pontos estabelecidos, sendo, neste instante registradas as micro deformações de cada extensômetro. Foi utilizado o teste de análise de variância T Student e o nível de significância foi o valor convencional de 5%. Para cada implante foi analisada a microdeformação ocorrida. Os resultados obtidos mostraram que houve uma diferença estatisticamente significativa entre os pontos não-axiais D e E (t = 5,21 df = 4, p = 0,006 < 0,05) e não foi estatisticamente significativa para os dados axial entre os pontos B e C (t = 6, 57, df = 4, p = 0,003 < 0,05 / 3). Conclui-se que,a aplicação de carga ao redor de três implantes de hexágono externo no posicionamento compensado,mostra que os pontos não-axiais sofrem maior micro deformação do que os pontos axiais

Restauración onlay usando técnica semi-directa con resina compuesta: reporte de un caso

Posterior teeth restorations have changed the contemporary treatment philosophy influenced by the aesthetic demand of patients, progress of adhesive material science and techniques for preservation and rehabilitation of affected teeth by dental caries and trauma. The development of Onlay restorations with semi-direct technique in endodontically teeth treated aims to preserve the remaining surfaces, to reduce the possibility of fracture and polymerization shrinkage. In addition, better restoration adaptation and marginal seal, resistance to wear and dimensional stability are achieved. This case reports the rehabilitation of an endodontically treated permanent maxillary first molar in a 13 years old- patient who attended the Araraquara School of Dentistry, Brazil, using Miris 2 Composite resin with semi-direct technique and obtaining an aesthetic and functional restoration in a single appointment. The fundaments and clinical guidelines of the procedure are detailed, based on the review of the literature that supports this conservative treatment.

Estudio histológico del processo de reparación alveolar después de la aplicación tópica de la solucioón anestésica prilocaína 3 % con felipressina o,o3 ui/ml

The aim of this study was to evaluate the local anesthetic solution, composed by Prilocaine 3% and felipressin 0,03 UI/ml, influence on the alveolar repair process in rats after dental extraction. This research was previously approved by the Ethic Committee in Research of the Masters Degree Program in Oral and Maxillofacial Surgery of the Marília University (UNIMAR), Marília, São Paulo, Brazil. It was an experimental, randomly controlled study, with bifactorial analysis (group control versus experimental group, in function of the postoperative times (2 X 4)). For the accomplishment of this study 32 rats were used (Rattus norvegicus, albinus, Wistar), males, adults, weighing between 280 and 320 grams. The animals were selected and divided into Group I (control) and Group II (Citocain 3%® - Prilocaine 3% with felipressin 0,03UI/ml) with 16 rats each; being four animals of the Group I and four of the Group II, destined to the euthanasia in the postoperative periods of 3rd, 7th, 15th and 24th days. The histological analysis with base in the developed methodology, allowed us to conclude that the anesthetic solution of Citocain 3%® applied with gauze compress on the surgical dental wound, produced tissue events that committed the basic biological principles, that are responsible for the regeneration of the gingival epithelium and the alveolar process repair in rats. The Group I presented better results in the alveolar repair when compared to the Group II.

Sistemas cerámicos puros parte 2: materiales, propiedades ópticas y consideraciones clínicas

While dentistry continues to advance, the aesthetic techniques have evolved in proceedings more effective, functional and biocompatible. Meanwhile, cosmetic dentistry has become a bit more complex and technically difficult. With improvement of the properties (physical and optical) of the ceramics and the establishment of a working protocol, ceramic restorations have become increasingly popular. Currently there are several ceramic systems have excellent optical properties such as opalescence, fluorescence, translucency, chromaticity, which allow the restoration to mimic the tooth structure. From the physical point of view has restored biomechanical integrity and strengthening the remaining tooth structure. All this has led the profession to experience the use of new ceramic systems ranging from conventional feldspathic ceramics to modem ceramic reinforced, injected or computer-aid made. The material selection should be based on clinical need, aesthetic and functional requirements, restoration site, prosthetic design and laboratory techniques. In this article we will deal with the characteristics of the materials, their optical properties and clinical considerations for proper selection.

Correlación entre diferentes métodos de evaluación de color en el clareamiento dental. Correlation between different methods for co

The aim of this study was to evaluate the correlation of color change on bleaching tooth through delta E (ΔE) by the spectrophotometer Spectroshade (SS) and digital program Scanwhite (SW). Methods: 25 patient volunteers were recruited from Operative Dentistry at Universidad de Chile Dental School, between 18 to 30 years, with good oral hygiene. Exclusion criteria: Previous experienced tooth bleaching, anterior restorations, cervical lesions, pain dental, pregnant patient, stained teeth, malposition of the teeth and periodontal pathology. The bleaching was made in two sessions with three different bleaching systems which were randomly. The assessment of color change through ΔE was made on the two upper central incisors (N=50) by the SS and SW. The color in the same teeth were measured before (T0) and after (T1) of the bleaching treatment. Data were analyzed using test Spearman correlation coefficient (Rho) with a significant level of 95%. Results: The results showed a positive and significant correlation (0.676), with a statistically significant difference (p<0.05). Conclusion: There is correlation in the measurement of color change on bleaching tooth by SS and SW.

Estado actual del blanqueamiento: sigue siendo un tratamiento seguro? review

The demand for cosmetic dentistry, including teeth whitening, has increased in recent years. The home teeth whitening and in-office, are widely used in dental practice. The mechanism by which it works is by oxidation of the chromogenic existing tooth structure. This is an effective and minimally invasive procedure that achieves tooth lighten the color, however, may cause alterations in the enamel surface, such as a dental permeability increase. Another effect caused by this procedure is tooth sensitivity, being the most common side effect, up to 65% of individuals have had a secondary effect at least once during treatment. This sensitivity and gingival irritation caused by bleaching may vary depending on the patient and used bleaching product

Adesivos multi-uso-avaliação da resistência adesiva a dentina frente a teste de cisalhamento, estereomicroscopia e microscopia eletrônica de varredura

Recent bonding systems have been advocated as multi-purpose bonding agents. The aim of this study was to determine if some of these bonding systems could be associated to composite resins from different manufacturers. This investigation was conducted to test lhe shear bond strength of three bonding systems: Scotchbond Multi-Purpose (3M Dental Products), Optibond Light Cure (Kerr) and Optibond Dual Cure (Kerr), when each of them was associated to lhe composite resins: Z1 00 (3M Dental Products), Prisma - APH (Dentsply) and Herculite XRV (Kerr). Seventy-two flat dentin bonding sites were prepared to 600 grit on human premolars mounted using acrilic resins. The teeth were assigned at random to 9 groups of 8 samples each. A split die with a 3mm diameter was placed over lhe surface of lhe dentin treated with one of lhe adhesive systems, and lhe selected composite resin was inserted and light cured. The split mold was removed and all samples were termocycled and stored in 37ºC water for 24 hours before testing. Shear bond strength was determined using an lnstron Universal testing machine. Some failures were examined under lhe S.E.M. Data was analysed by one-way analysis of variance, that demonstrated a significant difference (p<0,05) in the mean shear bond strength among Optibond Light Cure (15,446 MPa), Scotchbond Multi-Purpose (13,339 MPa) and Optibond Dual Cure (10,019 MPa). These values did not depend on the composite resin used. The association between bonding system/composite resin was statistycally significant (p<0,05) and the best results were obtained when the composite resins Z100 and Herculite were used with the adhesive system Optibond Light Cure, and when the composite resin APH was used with the adhesive system Scotchbond Multi-Purpose

Avaliação da biocompatibilidade de dois adesivos dentinários pelo estudo das reações teciduais em conjuntivo de ratos

The biocompatibility of two dentin adhesives (Scotchbond MultiPurpose- 3M and Optibond Multi-Use - Kerr) was evaluated in rats subcutaneous connective tissue implants. Polyethylene tubes filled with the adhesives were surgically implanted into the dorsal subcutaneous tissues of rats. The tubes were left implanted for periods of 14, 30, 60 and 84 days, following wich the animais were killed and the implants, together with the surrounding tissue, were excised. The specimens were then fixed in 10 per cent formalin, sectioned serially and stained with hematoxylin and eosin and then, examined by light microscopy. After 14 and 30 days the tubes were surrounded by a mild to moderate inflammatory infiltration. After 60 and 84 days microscopic examination revealed the formation of a connective tissue capsule around each tube. The microscopic examination of the biopsy specimens allowed to conclude that: a) both dentin adhesives are considered biologically acceptable when placed in contact with rats subcutaneous connective tissue; b) in the observation period of 30 days there were moderate tissue reaction to the Optibond Multi-Use -light cure- (Kerr); c) after 60 and 84 days the use of both dentine adhesives did not interfere in the healing of the surrounding connective tissue

Comparação termométrica entre preparos cavitários realizados com turbinas de alta-rotação e laser de Er:YAG

The aim of this study was to compare temperature increases produced by a well-known equipment, the high-speed handpieces, with a relatively new instrument, the Er:YAG laser (350 mJ/10 Hz). Thirty-five bovine mandibular incisors, which were reduced to an enamel/dentin thickness of 2,5 mm, were used. Cavity preparation was done till a depth of 2, 5 mm. A thermocouple was placed to read the temperature inside of the pulp chamber. Analysis was performed in these groups: I - high-speed handpiece without water-cooling (n=10); II - high-speed handpiece with water-cooling (n=10); III - Er:YAG laser without water-cooling (n=5); IV- Er:YAG laser with water-cooling (n=10) Group III had only 5 teeth because it was impossible to properly make the cavity preparations by the laser equipment without water cooling. The temperature increases were recorded in a computer linked to the thermocouples and the data of the groups I, II and IV were submitted to Dunn's multiple comparison test (p<0,05). The medium temperature increases were: 11,64ºC for group I, 0,96ºC for group II, 40,86ºC for group III and 2,9°C for group IV. There were no statistical differences between groups lI and IV, and these were different from group I. The cavity preparations made by the high-speed and the laser equipment generated very similar heat increases under water-cooling. The water-cooling is essential to avoid aggressive temperature increases, both when using the high-speed and the laser equipment, and with laser it is especially necessary for ablation of enamel

Estudo comparativo in vitro do efeito da ciclagem térmica sobre a resistência à tração de copings metálicos cimentados sobre dentes naturais, utilizando se de dois agentes cimentantes

Pós-graduação em Odontologia Restauradora - ICT

Saúde coletiva: promoção de saúde bucal na gravidez

Objective: The aim of this study was to analyze the perception and attitudes about oral health of pregnant women recorded on SIS-Prenatal from Bilac city, São Paulo State. Method: the data collection was through interviews with pregnant women using a semi-structured questionnaire. Pregnant women that were not present on attendance with gynecologist and those whose children were born were excluded of sample. Result: Among the  20 interviewed pregnant women, 80% didn’t received any type of information about oral health during pregnancy, 45% of total didn’t know how to maintain baby’s oral health,  85% didn’t know the mean of carie disease. The majority of pregnant women (95%) interested to make part of projects about promotion of oral health. Conclusion: the future mothers showed little knowledge in relation to preventive proceedings in dentistry and about diseases that could involve their and baby’s oral health. It’s necessary to perform programs about oral health, pointing the cares for mother-baby

Emprego de ma teriais rest auradores adesivos direto no ângulo incisal de incisivos centrais fra turados

A case report of a patient who presents as chief complaint presence of stained restorations in the anterior teeth. After analysis and discussion of the clinical therapeutic approaches to be adopted, it was observed the presence of type class IV restorations on teeth 11 and 21, due to an oblique coronal fracture in the past. But the patient was not satisfied with the aesthetic result, then where was planned the realization of the removal of the restorations, for subsequently be used direct restorative materials for the correction of form, function and esthetics. The final result showed that the restorations were able to return the form, function and aesthetic dental, thereby evidencing the proven development of restorative dentistry in the solution of aesthetic problems.

Cost-effectiveness of conventional and modified supervised toothbrushing in preventing caries in permanent molars among 5-year-old children

The cost-effectiveness of a modified supervised toothbrushing program was compared to a conventional program. A total of 284 five-year-old children presenting at least one permanent molar with emerged/sound occlusal surface participated. In the control group, oral health education and dental plaque dying followed by toothbrushing with fluoride dentifrice was carried outfour times per year. With the test group, children also underwent professional cross-brushing on surfaces of first permanent molar rendered by a dental assistant five times per year. Enamel/dentin caries were recorded on buccal, occlusal and lingual surfaces of permanent molars for a period of 18 months. The incidence density (ID) ratio was estimated using Poisson's regression model. The ID was 50% lower among boys in the test group (p = 0.016). The cost of the modified program was US$ 1.79 per capita. The marginal cost-effectiveness ratio among boys was US$ 6.30 per avoided carie. The modified supervised toothbrushing program was shown to be cost-effective in the case of boys.